In order to explore the relevance of social concepts such as stigma and denial to the transmission of HIV, this qualitative study sought to examine cultural and racial contexts of behaviour relevant to the risk of HIV infection among South Africans. A cultural model was used to analyse transcripts from 39 focus group discussions and 28 key informant interviews. Results reveal how cultural and racial positionings mediate perceptions of the groups considered to be responsible and thus vulnerable to HIV infection and AIDS. An othering of blame for HIV and AIDS is central to these positionings, with blame being refracted through the multiple prisms of race, culture, homophobia and xenophobia. The study's findings raise important questions concerning social life in South Africa and the limitation of approaches that do not take into account critical contextual factors in the prevention of HIV and care for persons living with AIDS.

Traditional healers play an important role in southern Africa culture and health care including the HIV epidemic. Here we report among the first controlled studies of an HIV/AIDS, sexually transmitted infections (STI) and tuberculosis (TB) intervention for traditional healers in South Africa. At baseline 233 traditional healers were assessed in four selected communities in the KwaZulu-Natal province and received either an experimental intervention or a no intervention control condition. The intervention group received training in HIV/AIDS, STI, and TB prevention over 3.5 days as well as a supervisory follow-up visit. At 7-9 months follow-up intervention effects were significant for HIV knowledge and HIV and STI management strategies including conducting risk behavior assessments and counseling, condom distribution, community HIV/AIDS and STI education, and record keeping. The study found a high level of preparedness among traditional healers to work with and refer patients to biomedical health practitioners, yet no higher levels of referral to biomedical practitioners were found after the training.

Background: Circumcisions undertaken in non-clinical settings can have significant risks of serious adverse events, including death. The aim of this study was to test an intervention for safe traditional circumcision in the context of initiation into manhood among the Xhosa, Eastern Cape, South Africa.

The aim of this study was investigate the HIV/AIDS/STI and TB knowledge, beliefs and practices of traditional healers in South Africa. In a cross-sectional study 233 traditional healers were interviewed in three selected communities in KwaZulu-Natal. Results indicate that the most common conditions seen were STIs, a variety of chronic conditions, HIV/AIDS (20%) and tuberculosis (29%). Although most healers had a correct knowledge of the major HIV transmission routes, prevention methods and ARV treatment, their knowledge was poorer on other HIV transmission routes, and 21% believed that there is a cure for AIDS. A minority reported unsafe practices in terms of reuse of razor blades on more than one patients and the reuse of enema equipment without sterilization, and two-thirds used gloves when carrying out scarifications. Randomized control trials are called for to test the effectiveness of traditional healing for HIV/AIDS, STI and TB prevention and care.

A cross-sectional explorative descriptive qualitative/quantitative study was conducted in the Eastern Cape of South Africa. The qualitative component involved 38 HIV/AIDS stakeholders who were interviewed telephonically using a semi-structured interview schedule. The quantitative component comprised 607 People Living With HIV/AIDS (PLWHA) who were interviewed using a structured questionnaire. The majority of PLWHA were female, never married, unemployed, aged between 26 to 45 years, Black African, and had more than grade 7 education. All stakeholders supported the disability grant (DG) because it improved the lifestyle of PLWHA. The CD4 count was cited as the main criterion for putting PLWHA on the DG. The conditions and characteristics of the DG were not clearly explained to PLWHA. The DG application process was viewed to be too long. Access to service points was perceived as a challenge for some PLWHA. The DG was used to meet basic household and health care needs. Not being on a DG was associated with lower CD4 counts, often without enough food, and less often without needed medicines in the past 12 months. Having the DG stopped was associated with often not having enough medicines that were needed in the past 12 months. We conclude that the DG is a lifeline for most HIV/AIDS-affected families. We recommend that DG should not use CD4 cell counts as criterion for DG eligibility; the conditions and characteristics of the DG should be fully explained to recipients; the DG application process should be completed within one day; PLWHA who no longer qualify for the DG yet do not have adequate financial means to meet basic necessities should be put on a nutritional support program; and access to the location of the grants by the poor and vulnerable should be improved.